Following. I’m in the same spot as you. Last Lupron shot a year ago and testosterone 54.

I was in a similar situation, having been on TRT for 14+ years before my diagnosis. My T level was 700+ when I was informed (late 2022). I stopped the injections immediately, and my T level dropped to 55. I started out getting Proton radiation treatments, followed by six months of Orgovyx (2023). My T level dropped to a resounding 15. The side effects of Orgovyx and low T caused significant issues, both physical and mental.

After what felt like an eternity, I was (grudgingly) given the approval to restart TRT, but agreed to a lower dosage and regular PSA tests. My first lowered dose was on 4/11/24, and almost immediately, I started to feel better. My new dose is .5ml, injected every 14-days (previously was 1ml), and my T level is in the 500's and most importantly, my PSA has remained low, most recently 0.25.

I would add that my Urologist made a similar comment about rising T levels, whether it occurs naturally or via TRT,

Following as well. It's been 15 months since my last Orgovyx pill and my T has only reached the low 200s. I feel slightly better, but not much, and am developing serious osteoporosis because my Estradiol level is only 4. Sexual health doctor says he's treated thousands of prostate cancer patients for low T and the recurrence rate isn't any higher than the not treated, but GP and oncology nurse are dead set against T supplementation, while oncologist isn't taking a side one way or the other.

Before ADT it was close to 600. It was 8-9 during Orgovyx treatment. Three months after stopping Orgovyx it briefly went up to 350 which was encouraging but then, every three months since, it's been dropping. I had my pituitary tested and my FSH levels are off the charts high so my brain is screaming to my body to make T but it just isn't doing it.

Any of you have used Enclomiphene to deal with fatigue?

I was out on TRT when my T didn't recover 2 years after triple therapy for G9 oligometastatic cancer. Mt PSA was undetectable and remained so for a year after TRT. Last week it was 0.2. There is no way to know if my PSA would have gone up without TRT or not. I know my QOL was hugely improved with TRT.

I believe current research is showing that TRT does not cause PSA to rise in selected patients and is beneficial.

Here is the abstract from a recent review article:

Review Article
Open access
Published: 26 November 2025
Testosterone replacement therapy following definitive treatment for prostate cancer: a scoping review of safety and efficacy

John Gibson, Michael George, Peter Grice, Amar Mohee, Theodora Stasinou, Ian Pearce & Vaibhav Modgil on Behalf of Manchester Andrology Research Collaborative (MARC)
International Journal of Impotence Research (2025)Cite this article

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Abstract
Testosterone replacement therapy (TRT) remains controversial in men with a history of prostate cancer due to historical concerns regarding oncologic safety. This scoping review aimed to systematically map existing evidence on the safety and efficacy of TRT in men following definitive treatment for prostate cancer. A systematic search of PubMed, CENTRAL, and Embase identified 447 records, from which 12 studies met inclusion criteria. Most were retrospective cohort studies, with sample sizes ranging from 10 to 152 men. TRT was not associated with an increased risk of biochemical recurrence or cancer progression in any included study. Reported PSA kinetics remained within expected post-treatment parameters, and several studies showed lower recurrence rates in TRT groups compared to controls. TRT consistently increased total and/or free testosterone and improved hypogonadal symptoms.

I completed 4 months of Orgovyx two years ago. I still had/have nasty side effects, including hot flashes, visceral fat, weakness and mild ED. I started TRT about 8 months ago, on advice of several Urologists and ROs. My T level rose from 250 to over 400, but, the side effects never stopped. I've been tapering off TGel and now only take 1 pump every other day since it doesn't cure my issues with this AWFUL drug that has seemingly rewired my hormonal system. My urologist also said that taking TGel will reduce my ability to produce it naturally. I've exhausted all the urologist paths having seen 3 from two different institutions. I have an appointment with endocrinology next to see if they can shed some light on the mystery. The Orgovyx side effects have been far worse than those from RT.

No worries Bro, I'll be 74 at the end of April. I eat a mediterranean diet and exercise daily. I ran a 5K while I was just starting Orgovyx. I haven't been able to run, even a 12 minute mile, since the 'crap' took over my system...as you can tell, I'm not happy with these life long side effects and would most likely not have taken the drug given my serious, but, highly speculative PCa diagnosis. 4 months is a very short prescription term.

To the best of my knowledge, there are no specific studies regarding safety of TRT specific to Gleason score or even precise timeframe after cessation of treatment or length of undetectable PSA. For me, having a very experienced MO familiar with the literature/studies with his/her own database of treated patients can provide the best guidance. We (the patient) must weigh the QOL derived from TRT against the possibility that the testosterone will stimulate growth of any dormant prostate cancer cells. Tough call.

I am 72 and have been very active my entire life. The 2 years I had testosterone near 0 I was very fatigued with little energy or enthusiasm. Hot flashes, muscle wasting, no libido (yes, that's still important to me), mental fog, mood swings and depression. I also wondered how much was age catching up to me vs. very low T.

The last year on TRT has been totally different. Hot flashes gone within a month, I have regained muscle and functional strength, my libido is back like it was years ago, my mood has brightened, the fog has lifted. My body hair has regrown and I have lost some fat around the middle and upper thighs. And this doesn't include the changes that I can't feel or identify. Like improved bone density and cardiovascular health. Like my MO at Hopkins told me right before putting me on TRT- "You are a 70 year old man living in a 90 year old body". And he was right.